Medicine and Health Sciences Commons^™

An Iterative, Low-Cost Strategy To Building Information Systems Allows A Small Jurisdiction Local Health Department To Increase Efficiencies And Expand Services, Kay Lovelace, Gulzar H. Shah

Health Policy & Management: Faculty Publications (2006-2018)

Objective and Methods: The objective of this case study was to describe the process and outcomes of a small local health department's (LHD's) strategy to build and use information systems. The case study is based on a review of documents and semi-structured interviews with key informants in the Pomperaug District Health Department. Interviews were recorded, transcribed, coded, and analyzed.

Results and Conclusions: The case study here suggests that small LHDs can use a low-resource, incremental strategy to build information systems for improving departmental effectiveness and efficiency. Specifically, we suggest that the elements for this department's success were simple information systems, …

Is Cloud Computing In Healthcare Providing A Safe Environment For Storing Protected Health Information? A Systematic Review And Meta-Analysis, Ashley N. Hayes

Applied Research Projects

Over the past several years, cloud computing has become increasingly more popular for the use of storing, accessing, and maintaining electronic health records (EHRs). In comparison to conventional EHR management tools, such as installed software, cloud computing offers more capabilities for medical facilities and their patients. Experts claim that in addition to changing the face of health information technology, it will also advance healthcare services, and benefit medical research. As the use of cloud computing has increased, so has the amount of healthcare data breaches. This study is proposing that there is a correlation between the increase in cloud computing …

How Barriers To Using The Electronic Health Record Effects Behavioral Healthcare, Jennifer Woodard

Applied Research Projects

The healthcare scene is rapidly changing due to the introduction of the electronic health record (EHR) and advances in technology. This means more patient data is readily available for use and gives physicians and patients’ faster access to that data. With the passing of recent legislature such as the Health Information Technology for Economic and Clinical Health Act and the American Recovery and Reinvestment Act of 2009, resulting in the rapid adoption of electronic health records due to incentive payment programs. With this comes the push for use of the electronic health record to prepare for Meaningful Use and improved …

Adoption Rate Of A Certified Ehr At Medical Practices With Five Or Fewer Physicians, Nelda Onwualiaobu

Applied Research Projects

The adoption rate of a certified electronic health record (EHR) for small medical practices have been the subject of discussion because prior research shows that larger medical practices have a higher rate of adoption than small medical practices. The major reason for this disparity has been the cost of adoption and implementation as many small practices are not financially equipped to shoulder this burden. The purpose of this research was to determine the adoption rate of a certified EHR for medical practices with five or fewer physicians. Through a google search and filtering the results of the search, the office …

Are Bay County Florida Healthcare Facilities Ready For Pama Imaging Cds Mandate?, Kelly Johnson

Applied Research Projects

The Electronic Health Record (EHR) has been a major player on the healthcare scene in recent years. Its use has ushered in a new phase of focus on quality healthcare combined with and aided by technological integration. Within this technological integration have come adjutant tools including Clinical Decision Support (CDS) tools. Among these applications are those focused on appropriate imaging by use of CDS designed according to Appropriate Use Criteria (AUC). The imaging CDS tools are available to aid the provider in selecting the appropriate imaging study for the clinical indications present. The Protecting Access to Medicare Act (PAMA) passed …

Methemoglobin And Nitric Oxide Therapy In Ugandan Children Hospitalized For Febrile Illness: Results From A Prospective Cohort Study And Randomized Double-Blind Placebo-Controlled Trial, Andrea Conroy, Michael Hawkes, Kyla Hayford, Laura Hermann, Chloe Mcdonald, Suparna Sharma, Sophie Namasopo, Robert Opoka, Chandy John, Conrad Liles

Paediatrics and Child Health, East Africa

Background: Exposure of red blood cells to oxidants increases production of methemoglobin (MHb) resulting in impaired oxygen delivery to tissues. There are no reliable estimates of methemoglobinemia in low resource clinical settings. Our objectives were to: i) evaluate risk factors for methemoglobinemia in Ugandan children hospitalized with fever (study 1); and ii) investigate MHb responses in critically ill Ugandan children with severe malaria treated with inhaled nitric oxide (iNO), an oxidant that induces MHb in a dose-dependent manner (study 2).

Methods: Two prospective studies were conducted at Jinja Regional Referral Hospital in Uganda between 2011 and 2013. Study 1, a …

“Running A Marathon Without Training”…Hospital Course And Outcomes Of 5 Patients Admitted With Ards Requiring Ecmo, Michael Pechulis Dpt, Kenneth Miller Med, Rrt-Nps, Rita Pechulis Md, Fccp

Patient Care Services / Nursing

No abstract provided.

Fetal Brain Lesions After Subcutaneous Inoculation Of Zika Virus In A Pregnant Nonhuman Primate, Kristina M. Adams Waldorf, Jennifer E. Stencel-Baerenwald, Raj P. Kapur, Colin Studholme, Erica Boldenow

University Faculty Publications and Creative Works

We describe the development of fetal brain lesions after Zika virus (ZIKV) inoculation in a pregnant pigtail macaque. Periventricular lesions developed within 10 d and evolved asymmetrically in the occipital-parietal lobes. Fetal autopsy revealed ZIKV in the brain and significant cerebral white matter hypoplasia, periventricular white matter gliosis, and axonal and ependymal injury. Our observation of ZIKV-associated fetal brain lesions in a nonhuman primate provides a model for therapeutic evaluation.

Predicting Walking Ability And Prosthetic Candidacy Following Lower Extremity Amputation: Systematic Review, Treatment Pathway And Algorithm, Scott Love

Student Dissertations

Purpose: The purpose of this study is a systematic review (SR) of existing literature to examine characteristics of persons with amputation which predict walking ability and prosthetic candidacy following lower extremity amputation (LEA). The identification, synthesis and summary of this evidence could assist in developing clinical practice guidelines, including a physical rehabilitation treatment pathway and a clinical algorithm. The importance of this project is the establishment to further develop evidence based LEA clinical practice guidelines. This evidence will assist the healthcare team in decision making, specifically considering evidence and patient-centric predictive characteristics.

Background: Currently, there is no multi-disciplinary physical …

Changes In Serum Lipid Profile Among Patients Suffering From Chronic Liver Disease Secondary To Hepatitis C, Fakhar Qazi, Shameem Behram Khan, Anam Umar, Noor Ul Saba Shaikh, Fizza Choudhry

Section of Gastroenterology

Objective: To find out the changes in lipid metabolism among patients suffering from chronic liver disease secondary to hepatitis C.

Study Design: Hospital based observational study.

Setting: Medical Unit-I, Ward–5, Jinnah Postgraduate Medical Centre, Karachi.

Duration: July 2013 to December 2013.

Patients and Methods: About 110 patients admitted in Medical Unit-I with a diagnosis of chronic liver disease were included in the study. Patients suffering from DM, HTN, CKD were excluded from the study. Fasting lipid profile was done in all cases.

Results and Observations: There were 44 (40%) male and 66 (60%) female patients. Mean age of the patients …

Premedical Programs Newsletter, November-December 2016, University Of Dayton

Pre-Health Resource Center Campus Communications

Newsletter for students, staff, and faculty in the premedical and predental programs.

A Word From The Writing Center (November 2016), Jennifer Wilson, Ms, Els

A Word From the Writing Team (Newsletter)

November 2016 issue includes:

• Writing Tip
• Learning Opportunity
• Writing Café

Effect Of Tai Chi On Vascular Function Among Patients With Peripheral Neuropathy, Arturo A. Arce-Esquivel, Joyce E. Ballard, Barbara K. Haas, Melinda Hermanns, Carol A. Rizer, Gary T. Kimmel, Yong T. Wang

Nursing Faculty Publications and Presentations

Foot pain due to Peripheral Neuropathy (PN) is one of the factors affecting walking ability. It has been reported that diminished vascular function contributes to a decrease in physical function in individuals with PN. Microvascular disturbances have been reported in humans with neuropathic pain. Tai Chi, a Chinese conditioning exercise, has been associated with enhanced endothelial function. However, the effect of Tai Chi training on microvascular function in patients with PN has not been studied. This study aimed to assess the effects of Tai Chi on vascular function (i.e., vascular reactivity) and functional exercise capacity among patients with PN. Thirty-seven …

Head And Neck Manifestations Of Eosinophilic Granulomatosis With Polyangiitis: A Systematic Review., Jared M. Goldfarb, Mindy R. Rabinowitz, Shristi Basnyat, Gurston G. Nyquist, Marc R. Rosen

Department of Otolaryngology - Head and Neck Surgery Faculty Papers

OBJECTIVE: To conduct the first and only systematic review of the existing literature on head and neck manifestations of eosinophilic granulomatosis with polyangiitis to guide clinical decision making for the otolaryngologist.

DATA SOURCES: PubMed, Cochrane Library, Scopus, and LILACS.

REVIEW METHODS: A systematic review of the aforementioned sources was conducted per the PRISMA guidelines.

RESULTS: From an initial 574 studies, 28 trials and reports were included, accounting for a total of 1175 patients with eosinophilic granulomatosis with polyangiitis. Among clinical and cohort studies, 48.0% to 96.0% of all included patients presented with head and neck manifestations. In a distinct group …

The Life Cycle Stages Of Pneumocystis Murina Have Opposing Effects On The Immune Response To This Opportunistic Fungal Pathogen, Heather M. Evans, Grady L. Bryant Iii, Beth A. Garvy

Microbiology, Immunology, and Molecular Genetics Faculty Publications

The cell wall β-glucans of Pneumocystis cysts have been shown to stimulate immune responses in lung epithelial cells, dendritic cells, and alveolar macrophages. Little is known about how the trophic life forms, which do not have a fungal cell wall, interact with these innate immune cells. Here we report differences in the responses of both neonatal and adult mice to the trophic and cystic life cycle stages of Pneumocystis murina. The adult and neonatal immune responses to infection with Pneumocystis murina trophic forms were less robust than the responses to infection with a physiologically normal mixture of cysts and …

Improving Burn Nursing Skills And Knowledge With Burn Specific Competencies, Reena M. Mishory Bsn, Rn, Julie Ashenfalder Bsn, Rn, Katherine S. Wreath Bsn, Rn

Patient Care Services / Nursing

No abstract provided.

Clinical Influences In The Multidisciplinary Management Of Small Renal Masses At A Tertiary Referral Center, Costas D. Lallas, Kymora Scotland, Michael Zhang, Daisey Schaeffer, Anne Calvaresi, Leonard G. Gomella, Daniel Brown, Colette Shaw, Edouard J. Trabulsi

Department of Urology Faculty Papers

Introduction We designed a multidisciplinary Small Renal Mass Center to help patients decide among treatment options and individualize therapy for small renal masses. In this model physicians and support staff from multiple specialties work as a team to evaluate and devise a treatment plan for patients at the same organized visit. Methods We retrospectively reviewed the records of 263 patients seen from 2009 to 2014. Monitored patient characteristics included age, Charlson comorbidity index, body mass index, nephrometry score, tumor size and estimated glomerular filtration rate. Univariate and multivariate analyses were performed to identify patient characteristics associated with each treatment choice. …

Faster Permutation Inference In Brain Imaging, Anderson M. Winkler, Gerard R. Ridgway, Gwenaëlle Douaud, Thomas E. Nichols, Stephen M. Smith

School of Medicine Publications

Permutation tests are increasingly being used as a reliable method for inference in neuroimaging analysis. However, they are computationally intensive. For small, non-imaging datasets, recomputing a model thousands of times is seldom a problem, but for large, complex models this can be prohibitively slow, even with the availability of inexpensive computing power. Here we exploit properties of statistics used with the general linear model (GLM) and their distributions to obtain accelerations irrespective of generic software or hardware improvements. We compare the following approaches: (i) performing a small number of permutations; (ii) estimating the p-value as a parameter of a negative …

Analysis Of The Efforts Of Urban And Rural Health Systems To Achieve Accountable Care Organization Target Goals For Dilated Eye Exams In Individuals With Diabetes, Michele Gilliam

Muskie School Capstones and Dissertations

This capstone project was designed to understand and analyze the completion rates for diabetic dilated eye exams within four different health systems participating in the MaineHealth Accountable Care Organizations (ACO). This research is valuable within the current US health care climate as health care providers have sought to evaluate the cost of care in terms of their value to payers. Moreover, many providers have elected to join the ACO in order to demonstrate better outcomes, improve the cost of care and to share programmatic content and tools to standardized care. Within this capstone, system level workflows and processes were evaluated …

The Development Of A Universally Accepted Sacral Fracture Classification: A Survey Of Aospine And Aotrauma Members., Gregory D. Schroeder, Mark Kurd, Christopher K. Kepler, James C. Krieg, Jefferson R. Wilson, Conor P. Kleweno, Reza Firoozabadi, Carlo Bellabarba, Frank Kandizoria, Klause J. Schnake, S. Rajesekaran, Marcel F. Dvorak, Jens R. Chapman, Luiz R. Vialle, F. C. Oner, Alex R. Vaccaro

Rothman Institute Papers

Study Design Survey study. Objective To determine the global perspective on controversial aspects of sacral fracture classifications. Methods While developing the AOSpine Sacral Injury Classification System, a survey was sent to all members of AOSpine and AOTrauma. The survey asked four yes-or-no questions to help determine the best way to handle controversial aspects of sacral fractures in future classifications. Chi-square tests were initially used to compare surgeons' answers to the four key questions of the survey, and then the data was modeled through multivariable logistic regression analysis. Results A total of 474 surgeons answered all questions in the survey. Overall …

Prescription Drug Abuse Communication: A Qualitative Analysis Of Prescriber And Pharmacist Perceptions And Behaviors, Nicholas E. Hagemeier, Fred Tudiver, Scott Brewster, Elizabeth J. Hagy, Angela Hagaman, Robert P. Pack

ETSU Faculty Works

Background: Interpersonal communication is inherent in a majority of strategies seeking to engage prescriber and pharmacist health care professionals (HCPs) in the reduction and prevention of prescription drug abuse (PDA). However, research on HCP PDA communication behavioral engagement and factors that influence it is limited. Objectives This study quantitatively examined communication behaviors and trait-level communication metrics, and qualitatively described prescription drug abuse-related communication perceptions and behaviors among primary care prescribers and community pharmacists. Methods: Five focus groups (N = 35) were conducted within the Appalachian Research Network (AppNET), a rural primary care practice-based research network (PBRN) in South Central …

Annotated Bibliography: Understanding Ambulatory Care Practices In The Context Of Patient Safety And Quality Improvement., Maria F. Montano, Harshal Mehdi, David B. Nash

College of Population Health Faculty Papers

The ambulatory care setting is an increasingly important component of the patient safety conversation. Inpatient safety is the primary focus of the vast majority of safety research and interventions, but the ambulatory setting is actually where most medical care is administered. Recent attention has shifted toward examining ambulatory care in order to implement better health care quality and safety practices. This annotated bibliography was created to analyze and augment the current literature on ambulatory care practices with regard to patient safety and quality improvement. By providing a thorough examination of current practices, potential improvement strategies in ambulatory care health care …

Implementation Of Technology-Based Patient Engagement Strategies Within Practice-Based Research Networks (Poster), Beth Careyva M.D., Kyle Shaak Bs, Geoffrey Mills Md, Phd, Melanie B. Johnson Mpa, Samantha A. Goodrich, Brian Stello Md, Lorraine S. Wallace Phd

Department of Family Medicine

Careyva, B. Shaak, K. Mills, G. Johnson, M. Goodrich, S. Stello, B. Wallace, L. (2016, Nov). Implementation of Technology-Based Patient Engagement Strategies within Practice-Based Research Networks. Poster Presented at: North American Primary Care Research Group, Colorado Springs, CO.

When Empathy Bites Back: Cautionary Tales From Neuroscience For Capital Sentencing, Sheri Lynn Johnson, Amelia Courtney Hritz, Caisa Elizabeth Royer, John H. Blume

Cornell Law Faculty Publications

The neuroscience of empathy provides one more reason to believe that the decision to sentence another human being to death is inevitably an arbitrary one, and one that cannot be divorced from either race or caprice. While we can tinker with aspects of capital trials that exacerbate caprice and discrimination stemming from empathy, we cannot alter basic neural responses to the pain of others and therefore cannot rationalize (in either sense of the word) empathic responses.

Urgent Challenges For Local Public Health Informatics, Joseph P. Gibson, Gulzar H. Shah, Laura C. Streichert, Linda Verchick

Health Policy & Management: Faculty Publications (2006-2018)

This editorial highlights the urgent challenges for local public health informatics and provides solutions to face these challenges.

The Methods Behind 2015 Informatics Capacity And Needs Assessment Study, Gulzar H. Shah

Health Policy & Management: Faculty Publications (2006-2018)

The 2015 Informatics Needs and Capacity of Local Health Departments (LHDs) survey is the most recent comprehensive source of quantitative data on LHD informatics. Conducted by the National Association of County & City Health Officials (NACCHO), this is the third nationally representative quantitative study of LHD informatics since 2009. The previous 2 comprehensive quantitative assessments were conducted by NACCHO in 2009-2010 and 2011. Given that public health informatics is rapidly evolving, the 2015 Informatics survey is a much-needed country-wide assessment of the current informatics needs and capacities of LHDs. This article outlines detailed methodology used in the 2015 Informatics survey, …

Csp And “Omics” Technology Applied On Versatile And Intelligent Portable Platform For Modeling Complex Bio-Medical Data, Florentin Smarandache, Luige Vladareanu, Mihaiela Iliescu, Hongbo Wang, Feng Yongfei, Victor Vladareanu

Branch Mathematics and Statistics Faculty and Staff Publications

This paper presents relevant aspects of the idea of using the digital medicine in cancer, so that to shape a viable strategy for creating and implementing an interactive digital platform, NEO-VIP, that should be the basic support to design the strategy for integration of basic, clinical and environmental research on neoplasia progression to cancer. The two main components of the VIPRO Platform are represented by the workstation “Engineering Station” for CPS (Cyber Physical System) and “omics” technology and by the “Graphical Station” for the development of a virtual mechatronic system environment and virtual reality for system components' motion. The NEO-VIP …

Postoperative Outcomes Of Robot-Assisted Laparoscopic Radical Prostatectomy From Initial 100 Cases At King Chulalongkorn Memorial Hospital, Suvapong Tantasutthanon, Kamol Panumatrassamee, Kavirach Tantiwongse, Julin Opanuraks, Supoj Ratchanon, Apirak Santi-Ngamkun

Chulalongkorn Medical Journal

Background : Prostate cancer is the second most frequently diagnosed cancer and the sixth leading cause of cancer death in males. Robot-assisted laparoscopic radical prostatectomy (RALP) is an evolving minimally invasive treatment for localized prostate cancer.Objective : We analyzed the perioperative outcomes of RALP from our initial 100 cases experience. Patients andMethods : From May 2011 to February 2015, 100 consecutive patients with clinical localized prostate cancer underwent RALP at our institution. All patients’ demographic data, postoperative parameters and pathological results were recorded and analyzed.Results : The mean age of the patients was 64 (45 - 80) years; mean preoperative …

Influence Of Beam Pitch And Tube Current On Lung Nodule 64- Mdct - Chest Protocol : A Phantom Study, Chatnapa Nuntue, Anchali Krisanachinda

Chulalongkorn Medical Journal

Background : Multi-Detector Computed Tomography (MDCT) is a powerful modality to detect small pulmonary nodules while the benefits of CT exceed the harmful effects of radiation exposure in patients; thus, CT doses should be kept as low as reasonably achievable. The way to reduce radiation dose is based on modification ofscanning parameters.Objective : The purpose of this study is to investigate the radiation dose and image quality affected by beam pitch and tube current for chest CT scan using a lung man phantom with lung nodules.Designs : Experimental study (in vitro).Setting : Department of Radiology, King Chulalongkorn Memorial hospital, Bangkok.Material …

แนวทางการจำแนกชนิดของความผิดปกติและการรักษาโรคกระดูกสันหลังเคลื่อน Isthmic Spondylolisthesis, นรา จารุวังสันติ

Chulalongkorn Medical Journal

Isthmic spondylolisthesis ในรายที่เป็น high grade สามารถทำให้เกิดความผิดปกติของsacro – pelvic orientation ซึ่งส่งผลให้เกิดความผิดปกติต่อ spine-pelvic orientation ร่วมด้วยในบทความนี้กล่าวถึง Spinal Deformity Study Group (SDSG) โดยการจำแนกแจกแจงความผิดปกติของ spino-pelvic และ sacro-pelvic orientation และแนวทางการรักษา โดยจะต้องคำนึงถึงระยะการเคลื่อน (slip), sacro-pelvic balance และ sagittal balance ของโครงสร้างกระดูกทั้งตัวและในบทความยังกล่าวถึงอาการต่าง ๆ ที่แสดงให้เห็นจากการถ่ายภาพรังสี ซึ่งเป็นตัวบ่งบอกถึงความเสี่ยงที่กระดูกเคลื่อนผิดแนวได้มากขึ้น.