Medicine and Health Sciences Commons^™

Patient Perspectives: Four Pillars Of Professionalism, Laura Yvonne Bulk, Donna Drynan, Sue Murphy, Patricia Gerber, Roberta Bezati, Sacha Trivett, Tal Jarus

Patient Experience Journal

Professionalism is a core component of healthcare practice and education; however, there is often not a consistent description of professionalism, and current definitions lack a key perspective: that of the patient. This study aimed to deepen understandings of patients’ perspectives on how professionalism should be enacted by healthcare providers. Using a phenomenological approach informed by constructivist theory, the study team conducted semi-structured interviews and focus groups with 21 patients to ascertain their views on professionalism. Data analysis was conducted using a constant comparative approach wherein initial analysis informed subsequent data collection. Participant themes fell into four pillars of professionalism: taking …

Patient-Initiated Second Opinions During Acute Hospital Care, Roni Gagin, Neta Hagani, Esti Zigelboim, Shiri Shinan-Altman

Patient Experience Journal

Second opinions are used in medicine in order to make better-informed decisions. Only a few studies have examined patient-initiated second opinions, and even fewer have examined it in the context of acute hospitalization. It is not clear whether patients and families are aware of this right and how often they exercise it during acute hospitalization. The objective of this paper is to identify factors associated with the awareness and utilization of patient-initiated second opinions. A survey was conducted among 92 neurosurgical patients who completed a questionnaire that included information regarding: awareness of second opinion consultations, reasons for not seeking a …

Using Patient Experience In Optimizing The Total Knee Arthroplasty Patient Journey, Nienke Wolterbeek, Dieuwertje J. Hiemstra, Fiona A. Van Der Hoeven, Kiem G. Auw Yang

Patient Experience Journal

Information was used to improve the patient journey and to achieve patient-centered care. Patients (>18 years, purposive sampling) were interviewed once at one point of their total knee arthrosis journey within the hospital setting. Patients were accompanied and observed during their hospital visit by one of the 19 healthcare professionals which were trained as interviewers. A qualitative research approach with in-depth and semi-structured interviews using a standardized interview guide were used to gather an in-depth understanding of the perceptions of patients. Interviews were written out with the emphasis on positive and negative feedback, quotes and observations that were made. …

Service User Interview Panels For Recruitment To Uk Child And Adolescent Mental Health Services: A Questionnaire Study Exploring The Experiences Of Young People, Staff And Candidates, Sophie M. Allan Ms, Emma Travers-Hill Dr

Patient Experience Journal

Service user involvement is increasingly important in health and social care policy, including in Child and Adolescent Mental Health Services (CAMHS), but evidence evaluating involvement initiatives is lacking. This questionnaire study evaluated the use of young people’s (YP) interview panels in the recruitment of CAMHS staff, from the perspectives of YP, candidates and members of the staff interview panels. Self-report questionnaires were administered to YP, candidates and staff interview panel. This included quantitative and qualitative “free text” responses. YP’s panels were found to be important in hearing the voices of YP; participants all stated they would like YP to take …

From Diagnosis To Routine Care In Type 1 Diabetes In Children: Parents’ Experiences, Géraldine Heilporn, Maude Laberge, André Côté, Monia Rekik

Patient Experience Journal

Having a child who lives with a Type 1 Diabetes (T1D) can represent a high burden for parents. The objective of our study is to identify and analyze the main challenges expressed by parents so that health care services better meet the needs of parents of T1D children. Semi-structured interviews were conducted with parents of 19 T1D children regarding detection and diagnosis, initial management at the hospital, post-discharge adaptation including daycare or school reintegration, and long-term T1D monitoring. Data analysis was performed following an inductive approach. The results showed a lack of knowledge regarding T1D in the society, especially for …

Refugees' Perceptions Of Primary Care: What Makes A Good Doctor's Visit?, Anne Mutitu, Bev Zabler, Jeana M. Holt

Patient Experience Journal

Redesigning primary care is a national priority, as the United States (US) struggles with issues of poor access, high cost, and suboptimal quality. Refugees are among the populations who suffer from America’s disjointed health care system, resulting in disproportionate health disparities. Although there are many studies on refugee health, few share refugees' perceptions of primary care. We asked local refugees who were seen for primary care services at a midwestern academic nurse-led clinic, what makes a good doctor's visit?  The clinic served as the hub of a federally funded refugee Community Centered Health Home (CCHH) pilot project. This qualitative study …

Engaging Under- And/Or Never-Engaged Populations In Health Services: A Systematic Review, Lesley Moody, Erica Bridge, Vidhi Thakkar, Naomi Peek, Tanvi Patel, Suman Dhanju, Simron Singh

Patient Experience Journal

Patient engagement is a mechanism used to facilitate person-centred care, however, has not been realized in all patient populations. Often, many marginalized populations still remain under- and/or never-engaged. The purpose of this systematic review was to: 1) identify methods or interventions that have been used to engage under- and/or never-engaged populations in health services and 2) identify outcomes that are associated with engaging under- and/or never-engaged populations in health services. A comprehensive search using the Ovid MEDLINE, EMBASE and CINAHL databases was conducted to examine literature between January 2002 and January 2015. Twenty-nine studies met the inclusion criteria. Data was …

Is It Fair To Compare? A Patient And Family Experience Of Two Healthcare Systems And Neurosurgical Teams Within A Two-Week Period, Laura Miller Cpxp

Patient Experience Journal

As the mother of a 28-year-old son with cerebral palsy and hydrocephalus, and as a healthcare consultant focused on patient experience and professional development, I have a unique perspective and skill set. Recently he experienced symptoms that included an excruciating headache, neck pain and lethargy. Fearing his ventriculoperitoneal shunt had malfunctioned, he went to the emergency room and was later admitted on the neuro inpatient floor for a three-day hospitalization. His original shunt had been placed in 1991, and he never had an issue with until August 2018. While in the hospital, he was informed that he was no longer …

Awakening From A Medical Mystery: One Patient’S Experience Of Being Undiagnosed, Dwane Unruh

Patient Experience Journal

This personal narrative pleads for a supportive and comprehensive system or sub-system similar to that which exists for cancer patients, to deal with undiagnosed illnesses. By describing the torment of living with a debilitating illness that medicine could not easily recognize, then by contrasting this experience with my wife’s experience of the cancer care system, and by referring along the way to lessons learned many years ago from reading the works of the inciteful neurologist, Dr. Oliver Sacks, I hope to inspire the medical system to develop a separate, supportive and comprehensive system to deal with the undiagnosed. As it …

The Future Of Patient Experience: Five Thoughts On Where We Must Go From Here, Jason A. Wolf Phd, Cpxp

Patient Experience Journal

In looking to the future, we must never forget it is grounded in today and the steps that brought us to this point. Those efforts and actions that led to where we stand now set the foundation for all we can do and what we will accomplish as we look to the future. This idea of not looking too far ahead without knowing where you stand is fundamental in human nature. Far too often we have let our gaze to the future miss the people right in front of us or overlook the significance of the moment in which we …

The Effects Of Caffeine Ingestion On The Hemostatic Response To Simulated Firefighting Activities, Sierra Wassell

Showcase of Graduate Student Scholarship and Creative Activities

The leading cause of death among firefighters is sudden cardiac event, and it is acknowledged that most ischemic events are due to an occlusive thrombus formation. In addition, due to the demanding job requirements and shift work, firefighters are commonly known to overuse caffeine as an ergogenic aid. The purposes of this study were to examine the potential effects of caffeine on the hemostatic response to simulated firefighting activity.

Bout Vs. Non-Bout Physical Activity Minutes As Predictors Of Waist Circumference In College Students, Valerie Olijar, Matt Scott, Brooke Ferraro, Elizabeth Edwards, Trent Hargens

Showcase of Graduate Student Scholarship and Creative Activities

Physical activity recommendations to reduce all cause mortality consist of 10 minute bouts of a moderate-vigorous intensity, for a total of 150 min/week. This study investigates if those 10 minute bouts really matter. We found that step count was the best predictor of waist circumference. This finding supports many new technological devices that use step counts as a form of measuring activity. It provides support that the more steps you take, the likelier you will have a small waist.

The Effect Of Oral Contraceptives On Caffeine Metabolism And Cycling Performance, Annette M. Lemanski

Showcase of Graduate Student Scholarship and Creative Activities

This project objectives were to determine the effects of oral contraceptives and menstrual cycle on the benefits of caffeine supplementation for cycling performance. Seventeen recreationally trained female cyclists completed four trials consisting of 3 kilometer time trials. Subjects ingested either caffeine or a placebo one hour prior to each trial. The magnitude of the ergogenic aid of caffeine was compared between oral contraceptive users and eumenorreheic females. In addition, the effect of caffeine was compared across different phases of the menstrual cycle, specifically the follicular and luteal phases.

Distractions In Hearing: Measuring Impulsivity In Service Members With Mtbi, Kathleen Burns

Showcase of Graduate Student Scholarship and Creative Activities

Service Members who have experienced mild traumatic brain injury (mTBI) tend to experience a degradation of focus and attention capabilities. The purpose of this initial pilot study is to measure the false alarm rates and thresholds of Service Members with mTBI during contralateral and informational masking tests and compare their outcomes to adults without mTBI. Contralateral and informational masking tasks both involve different levels of uncertainty and different forms of central masking. These two tasks will be used to quantify the participants’ accuracy in identifying the target stimulus and their associated levels of distractibility and impulsivity. Preliminary data obtained from …

Development Of A Questionnaire To Assess Attitudes Toward Hearing Aids, Corinne O'Shaughnessy, Ayasakanta Rout, Joseph Smaldino

Showcase of Graduate Student Scholarship and Creative Activities

Many reasons have been postulated as to why persons with hearing loss are reluctant to engage in the hearing rehabilitation process. While not the only determinant, an individual’s attitudes toward hearing loss and hearing aids have been shown to affect adoption of amplification adversely and eventual outcomes of hearing aid use. Several attempts have been made to develop test instruments for attitudes toward hearing loss, but nothing specific to attitudes toward hearing aids or hearing aid technology. The primary objective of this study was to develop a questionnaire to assess attitudes toward hearing aids using the ABC model of attitude …

Exploring The Impact Of An Occupation-Based Group On Self-Esteem And Self-Concept, Christie E B Briskey, Elyse Marie Powderly

Showcase of Graduate Student Scholarship and Creative Activities

Due to the need for an occupation-focused intervention for childhood cancer survivors, we will be conducting a five week group occupation-based program to explore its impact on self-concept and self-esteem in childhood cancer survivors through occupational exploration and participation. The purpose of our study is to determine the efficacy of a group occupation-based intervention on enhancing areas of psychological well-being such as self-esteem and self-concept in childhood cancer survivors in order to support their transition from childhood to adolescence. Each week we will guide the participants through various activities with creative and self-expressive components such as poetry writing, creative movement, …

The Effect Of Parent-Infant Swim Classes On Maternal Parenting Competence, Emotional Availability, And Aquatic Handling, Hope Sadowski, Chanele Molano

Showcase of Graduate Student Scholarship and Creative Activities

Low parenting competence and limited emotional availability decrease the quality of the parent-infant relationship (Young, 2011; Sturge-Apple et al., 2012). However, co-occupations, or reciprocal relationships where the occupations of two or more individuals are interactively shaping each other, have been associated with strengthening parent-infant relationships (Pierce, 2009; Price & Stephenson, 2009). Parent-infant swim classes are co-occupation based interventions that facilitate close bodily contact and teach parents handling skills that can generalize into the home. Numerous websites allude to the benefits of these classes; however, there are currently no evidence-based claims supported by the occupational therapy literature. The researchers hypothesized that …

Sustainable Solutions, Fall/Winter 2020, Issue 41

Sustain Magazine

No abstract provided.

‘A Healthy Cit’: An Investigation Into Student Health Metrics, Lifestyle Behaviours And The Predictors Of Positive Mental Health In An Irish Higher Education Setting, Andrea Bickerdike, Joan Dineen, Cian O'Neill

Publications

Higher Education Institutions (HEIs) are potent health promotion settings, uniquely positioned to aid societal efforts to combat non-communicable diseases (NCDs). International evidence suggests that health metrics and lifestyle behaviours of higher education students are sub-optimal, yet a dearth of contemporary Irish data exists. This study aimed to examine sex differences in student lifestyle behaviours and identify significant predictors of positive mental health in an Irish HEI setting. An online questionnaire instrument distributed to all registered students (n = 11,261) gathered data regarding a multitude of health and lifestyle domains. Many items were adapted from previous Irish research. Further validated scales …

Therapeutic Administration Of Tregitope-Human Albumin Fusion With Insulin Peptides To Promote Antigen-Specific Adaptive Tolerance Induction., Anne S De Groot, Gail Skowron, James Robert White, Christine Boyle, Guilhem Richard, David V. Serreze, William D Martin

Faculty Research 2019

Type 1 Diabetes (T1D) is an autoimmune disease that is associated with effector T cell (Teff) destruction of insulin-producing pancreatic beta-islet cells. Among the therapies being evaluated for T1D is the restoration of regulatory T cell (Treg) activity, specifically directed toward down-modulation of beta-islet antigen-specific T effector cells. This is also known as antigen-specific adaptive tolerance induction for T1D (T1D ASATI). Tregitopes (T regulatory cell epitopes) are natural T cell epitopes derived from immunoglobulin G (IgG) that were identified in 2008 and have been evaluated in several autoimmune disease models. In the T1D ASATI studies presented here, Tregitope peptides were …

Evaluation Of 16s Rrna Gene Sequencing For Species And Strain-Level Microbiome Analysis., Jethro Johnson, Daniel Spakowicz, Bo-Young Hong, Lauren M Petersen, Patrick Demkowicz, Lei Chen, Shana Leopold, Blake M Hanson, Hanako O Agresta, Mark Gerstein, Erica Sodergren, George M. Weinstock

Faculty Research 2019

The 16S rRNA gene has been a mainstay of sequence-based bacterial analysis for decades. However, high-throughput sequencing of the full gene has only recently become a realistic prospect. Here, we use in silico and sequence-based experiments to critically re-evaluate the potential of the 16S gene to provide taxonomic resolution at species and strain level. We demonstrate that targeting of 16S variable regions with short-read sequencing platforms cannot achieve the taxonomic resolution afforded by sequencing the entire (~1500 bp) gene. We further demonstrate that full-length sequencing platforms are sufficiently accurate to resolve subtle nucleotide substitutions (but not insertions/deletions) that exist between …

N-Of-1 Trials As A Decision Support Tool In Clinical Practice: A Protocol For A Systematic Literature Review And Narrative Synthesis, Joyce Samuel, Travis Holder, Donald Molony

Library Staff Publications

The n-of-1 trial can utilized in clinical practice as a decision support tool, which may improve patient outcomes by providing both the patient and the clinician with objective evidence to inform personalized treatment decisions. As its use broadens, it will be important to study whether the added time and effort of an n-of-1 trial results in measurable improvements in important patient outcomes compared to usual clinical practice. Parallel-group randomized clinical trials testing the n-of-1 approach versus usual care have been undertaken in a number of medical settings. A systematic review will be performed according to PRISMA guidelines, using MEDLINE, Embase, …

Floor Of Mouth Thyroglossal Duct Cyst: A Rare Embryologic Course., John Kerr, Weston L Niermeyer, Peter B Baker, Tendy Chiang

Surgery Articles

A thyroglossal duct cyst (TGDC) is a common pediatric midline neck mass. Most TGDCs occur in the region of the hyoid bone but have been found less commonly in areas from the oral cavity to the sternum. We present the first reported case of a multifocal floor of mouth (FOM)/cervical TGDC representing an atypical embryonic course. We also review atypical presentations of TGDC and provide a summary of cases involving FOM and multifocal cysts.

The Role Of Adaptive Immunity In Chronic Hypoxia-Induced Pulmonary Hypertension, Levi David Maston

Biomedical Sciences ETDs

Inflammation is a prominent pathologic feature in pulmonary arterial hypertension as demonstrated by pulmonary vascular infiltration of inflammatory cells, including T and B lymphocytes. However, the contribution of the adaptive immune system is not well characterized in pulmonary hypertension (PH) caused by chronic hypoxia (CH). Inflammatory cells, through various mechanisms, have the capability to increase pulmonary vascular resistance in various disease states. CD4⁺T cells have the potential to play a significant role in the disease process initiated by hypoxia. CD4⁺T cells are largely responsible for orchestrating downstream immune processes and are critical in focusing and amplifying …

Induction Techniques That Reduce Redistribution Hypothermia: A Prospective, Randomized, Controlled, Single Blind Effectiveness Study., Jonathan V. Roth, Leonard E. Braitman, Lacy H. Hunt

Student Papers, Posters & Projects

BACKGROUND: While much effort has been devoted to correcting intraoperative hypothermia, less attention has been directed to preventing redistribution hypothermia. In this study, we compared three different anesthetic induction techniques to standard IV propofol inductions (control) in their effect on reducing redistribution hypothermia.

METHODS: Elective, afebrile patients, age 18 to 55 years, were randomly assigned to one of four groups (n = 50 each). Group "INH/100" was induced with 8% sevoflurane in 100% oxygen, Group "INH/50" with 8% sevoflurane in 50% oxygen and 50% nitrous oxide, Group "PROP" with 2.2 mg/kg propofol, and Group "Phnl/PROP" with 2.2 mg/kg propofol immediately …

Pain, Functional Disability, And Their Association In Juvenile Fibromyalgia Compared To Other Pediatric Rheumatic Diseases., Mark Connelly, Jennifer E Weiss, Carra Registry Investigators

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Severe pain and impairments in functioning are commonly reported for youth with juvenile fibromyalgia. The prevalence and impact of pain in other diseases commonly managed in pediatric rheumatology comparatively have been rarely systematically studied. The objective of the current study was to determine the extent to which high levels of pain and functional limitations, and the strength of their association, are unique to youth with juvenile primary fibromyalgia syndrome/JPFS) relative to other pediatric rheumatic diseases.

METHODS: Using data from 7753 patients enrolled in the multinational Childhood Arthritis and Rheumatology Research Alliance (CARRA) Legacy Registry, we compared the levels and …

Impact Of The Human Footprint On Anthropogenic Mortality Of North American Reptiles, Jacob E. Hill, Travis L. Devault, Jerrold L. Belant

United States Department of Agriculture Wildlife Services: Staff Publications

Human activities frequently result in reptile mortality, but how direct anthropogenic mortality compares to natural morality has not been thoroughly investigated. There has also been a limited examination of how anthropogenic reptile mortality changes as a function of the human footprint. We conducted a synthesis of causespecific North American reptile mortality studies based on telemetry, documenting 550 mortalities of known cause among 2461 monitored individuals in 57 studies. Overall 78% of mortality was the result of direct natural causes, whereas 22% was directly caused by humans. The single largest source of mortality was predation, accounting for 62% of mortality overall. …

Multimodal Treatment And Neoadjuvant Chemotherapy Trends, Utilization And Survival Effects In Intrahepatic Cholangiocarcinoma – A Propensity Score Analysis, Ovie Utuama

USF Tampa Graduate Theses and Dissertations

Intrahepatic Cholangiocarcinomas (ICC) are fatal malignancies common among the elderly. Patients are diagnosed late and often relapse, even after curative-intent surgery (CIS). In this context, additional systemic chemotherapy (multimodal treatment) is recommended for most patients but reported survival benefits are minimal and are limited to small single institutional studies. For this reason, using a national cancer registry, we sought to characterize multimodal treatment trends and utilization in general and neoadjuvant chemotherapy, specifically, as well as evaluate their survival effects among the larger population. We hypothesized that, 1). Elderly ICC patients would have survival benefits equivalent to younger patients, 2). Neoadjuvant …

Adolescents Information Behaviour Of Substance Use Risks In Nigeria, Ruth Owolabi

Library Philosophy and Practice (e-journal)

Abstract

Adolescence is a transitory period in every human developmental process. The adolescent age is characterized by changes in the world view as such are exposed to making experiments. This could be as a result of peer influence that leads to a delinquent act of substance use. Substance use among adolescents in Nigeria is increasing at an alarming rate with risks on health which has become a global issue of concern. Despite the efforts by government and non-government agencies to create awareness on the risks of substance use there still exists evidence of its widespread in all the geographical areas …

Assessing The Lack Of Transgender Participation In Sports, Joseph Stavely, Lindsey Keenan

Ramifications

Transgender athletes face many challenges when attempting to participate in sport competitions. Facing these challenges causes many transgender athletes to abandon their sport. Whether it be a lack of adequate locker rooms, or fearing to show themselves in public, transgender athletes face many roadblocks on their path to sport achievement. Many of these roadblocks cause a transgender athlete to lose interest in the sport they love and create the potential to affect participation in sports and physical activity all together. It is clear sports and physical activity participation is lower in transgender athletes than participation by cisgender athletes due to …