Medicine and Health Sciences Commons^™

Factors Associated With Participation In The Oregon Summer Food Program: A Mixed Methods Analysis, Alethea Chiappone, Teresa M. Garvin, Casey Blaser, Hollyanne E. Fricke, Lisa Weissenburger-Moser Boyd, Tom Barnard, Amy L. Yaroch

Journal of Health Disparities Research and Practice

The Summer Food Service Program (SFSP) was established to ensure children eligible for the National School Lunch Program (NSLP) continue to receive meals outside of the school year. However, participation in SFSP is relatively low (2.8 million annually) when compared with NSLP participation (30.4 million annually), suggesting that challenges exist in reaching children. Using a mixed methods approach, this study explored factors associated with SFSP participation. A secondary data analysis of the Oregon SFSP identified factors associated with SFSP participation at the Oregon SFSP-, sponsor-, and site-levels. Semi-structured interviews with SFSP sponsors explored barriers and facilitators to SFSP participation. Results …

Interoperable Knowledge Modeling In Emergency Care: Application Of The Hl7 Emergency Care Domain Analysis Model, James C. Mcclay, Laura Heermann Langford

Posters and Presentations: Emergency Medicine

The Emergency Care System (ECS) in the United States provides intermittent unscheduled care to an increasing number of patients annually. Every ECS patient encounter generates data in a myriad of unlinked systems at regional emergency services and hospitals. Often, their prior health records are not available in a timely manner, fragmented, or not found. To address availability and interoperability data relevant to emergency care, the Health Level Seven (HL7) Emergency Care Workgroup seeks to ensure evolving health data interoperability standards incorporate ECS considerations. Foundational to that effort is a comprehensive model of Emergency Care information. This emergency care domain analysis …

Self-Care Trajectories And Reference Percentiles For Children With Cerebral Palsy., Robert J Palisano, Lisa A Chiarello, Lisa Avery, Steven Hanna, On Track Study Team

Physical Therapy Publications

Aims: To create longitudinal trajectories and reference percentiles for performance in self-care of children with cerebral palsy (CP).

Methods: Participants were 708 children with CP, 18 months through 11 years of age and their parents residing in 10 regions across Canada and the United States. Gross Motor Function Classification System (GMFCS) levels were determined by consensus between parents and therapists. Parents' completed the Performance in Self-Care domain of the Child Engagement in Daily Life Measure two to five times at 6-month intervals. Nonlinear mixed-effects models were used to create longitudinal trajectories. Quantile regression was used to construct cross-sectional reference percentiles. …

Computational Processing And Quality Control Of Hi-C, Capture Hi-C And Capture-C Data., Peter Hansen, Michael Gargano, Jochen Hecht, Jonas Ibn-Salem, Guy Karlebach, Johannes T Roehr, Peter N Robinson

Faculty Research 2019

Hi-C, capture Hi-C (CHC) and Capture-C have contributed greatly to our present understanding of the three-dimensional organization of genomes in the context of transcriptional regulation by characterizing the roles of topological associated domains, enhancer promoter loops and other three-dimensional genomic interactions. The analysis is based on counts of chimeric read pairs that map to interacting regions of the genome. However, the processing and quality control presents a number of unique challenges. We review here the experimental and computational foundations and explain how the characteristics of restriction digests, sonication fragments and read pairs can be exploited to distinguish technical artefacts from …

Teaching Medical Students Optimal Consulting Skills: The Challenge Of Generating Better Referring Physicians., Andrew W Phillips, Terence Potter, Brittany Z Dashevsky, Nicholas Masse, Brent Greenberg, Christopher M Straus

Articles, Abstracts, and Reports

Rationale and objectives We sought to incorporate a new teaching module into the traditional medical student radiology clerkship, to improve the necessary skills for future referring physicians. Materials and methods A new required and graded module was introduced in 2014 into the radiology clerkship in year three of medical school: the Mystery Case. Each student was provided a unique and undifferentiated case from a dedicated teaching file containing de-identified images and requisition data. Students were expected to complete three serial tasks over one week: 1) prepare a voice recognition-derived, structured radiological report utilizing appropriate and relevant vocabulary; 2) discuss pertinent …

A Survey Of Healthcare Workers On Safe Patient Handling And Mobility Resource Availability, Utilization, And Adherence, Kimberly Waltrip

Dissertations

The purpose of this study was to examine the current status of safe patient handling and mobility—specifically resource availability, utilization, and adherence to established safe patient handling and mobility standards—and measure any relationships among these factors. This study builds on the reliability and validity of the adapted American Nurses Association’s (2016) Safe Patient Handling and Mobility Self-Assessment Resource. Responses came from a one-shot survey of healthcare workers in direct patient care across several private and Veterans Health Administration healthcare organizations in the Midwestern United States. The risk of injury is higher in patient handling than in many other professions; …

Cardioprotective Effects Of Sphingosine-1-Phosphate Receptor Immunomodulator Fty720 In A Clinically Relevant Model Of Cardioplegic Arrest And Cardiopulmonary Bypass, Naseer Ahmed, Adeela Mehmood, Daniele Linardi, Soban Sadiq Sadiq, Maddalena Tessari, Sultan Ayoub Meo, Rehana Rehman, Waseem M. Hajjar, Nazeer Muhammad, Mohammad Iqbal, Anwar Gilani, Giuseppe Faggian, Alessio Rungatscher

Department of Biological & Biomedical Sciences

Objective: FTY720, an immunomodulator derived from sphingosine-1-phosphate, has recently demonstrated its immunomodulatory, anti-inflammatory, anti-oxidant, anti-apoptotic and anti-inflammatory properties. Furthermore, FTY720 might be a key pharmacological target for preconditioning. In this preclinical model, we have investigated the effects of FTY720 on myocardium during reperfusion in an experimental model of cardioplegic arrest (CPA) and cardiopulmonary bypass.
Methods: 30 Sprague-Dawley rats (300-350 g) were randomized into two groups: Group-A, treated with FTY720 1 mg/kg via intravenous cannulation, and Group-B, as control. After 15 min of treatment, rats underwent CPA for 30 min followed by initiation of extracorporeal life support for 2 h. Support …

Increasing Advanced Care Planning In An Ambulatory Care Setting, Jennifer Aronson, Elizabeth Eisenhardt, Ruth Hanselman, Suneela Nayak, Stephen Tyzik, Amy Sparks

Operations Transformation

Maine is experiencing an increasing percentage of its population being over 65 years old. Advanced Care Planning (ACP) is an important part of this aging population medical care so those ends of life preferences are known well in advance. An adult internal medicine clinic in a large academic tertiary medical center decided to create a performance improvement project that addressed ACP with embedded workflows.

The goal of this project was to have a minimum of 40% of patients 65 or older have an Advanced Care Directive or Serious Illness Conversation documented in EPIC.

Baseline metrics demonstrated that ACP discussion rates …

The Ward-Based Nurse Clinical Educator: Impact On Student Learning Outcomes And Student And Preceptor Experiences, Karen Ann Mccarthy

Theses: Doctorates and Masters

Aim

This study aimed to determine the impact of the implementation of a ward based Nurse Clinical Educator (NCE) role on students and staff at one health service whilst students were on clinical practicum at a Western Australian regional health care facility.

Question

The research question was: “What impact does the NCE support intervention have on students and clinical staff during clinical practicum?” Background Clinical experience for undergraduate student nurses (students) undertaking their bachelor’s degree is of utmost importance for gaining both competence and registration. Students encounter difficulties in obtaining opportunities to practice their skills and develop competence when on …

Astigmatic Correction With Implantation Of A Light Adjustable Vs Monofocal Lens: A Single Site Analysis Of A Randomized Controlled Trial, Majid Moshirfar, William D. Wagner, Steven H. Linn, David F. Skanchy, Tanner W. Brown, Aaron T. Gomez, Jackson L. Goldberg, Yasmyne C. Ronquillo, Phillip C. Hoopes

School of Medicine Publications

AIM

To evaluate the light adjustable lens (LAL) vs a standard monofocal lens in achieving target astigmatic refraction and improving postoperative uncorrected distance visual acuity (UDVA).

METHODS

This randomized controlled clinical trial included 40 patients with pre-existing astigmatism and visually significant cataract. Twenty-eight patients received the LAL and 12 control patients received a monofocal intraocular lens (IOL) after cataract extraction at a single institution. The patients with the LAL underwent adjustment by ultraviolet (UV) light postoperatively plus subsequent lock-in procedures and all patients returned to clinic for follow up of study parameters at 6, 9, and 12mo. Manifest refraction, distance …

Enoxaparin Dosing For Venous Thromboembolism Prophylaxis In Low Body Weight Patients., Daniel Dybdahl, Grant Walliser, Michelle Pershing, Christy Collins, David Robinson

OhioHealth Research Institute Articles

BACKGROUND: The appropriate dose of enoxaparin for venous thromboembolism (VTE) prophylaxis in low body weight patients is unknown.

OBJECTIVE: The aim of this study is to evaluate the impact of enoxaparin dosing on major and minor bleeding events in low body weight patients.

METHODS: This was a retrospective cohort study of patients weighing less than 45 kg receiving subcutaneous (SC) enoxaparin for VTE prevention. The primary objective was to determine whether enoxaparin dose was associated with major and minor bleeding. The secondary objective was to determine the incidence of VTE by enoxaparin dose.

RESULTS: There were 173 patients included in …

Cc Chemokine Ccl1 Receptor Ccr8 Mediates Conversion Of Mesenchymal Stem Cells To Embryoid Bodies Expressing Foxp3+Ccr8+ Regulatory T Cells, Nasreen Haque, Tuteja Akaash, Niloufar Haque

Publications and Research

Embryoid bodies (EBs) are three dimensional aggregates of pluripotent stem cells primarily used to investigate morphogenesis and cell toxicity, are also attractive tools in regenerative medicine. While embryonic stem cells (ESCs) and induced pluripotent cells (IPSCs) have been shown to form EBs in mouse, primate and humans, EB formation have not been previously demonstrated in mesenchymal stem cells (MSCs). Here we show that rat MSCs form EBs; which express regulatory T cell (Treg) marker Foxp3 and CC chemokine CCL1 receptor CCR8. We show a novel method for formation of EBs from MSCs under stress and demonstrate that the induction of …

Data From: Docosahexaenoic Acid Consumption Impedes Early Interferon- And Chemokine-Related Gene Expression While Suppressing Silica-Triggered Flaring Of Murine Lupus, Abby D. Benninghoff, James Pestka

Browse all Datasets

The dataset contains five files of tabular data with an accompanying README file.

Supplementary file 1: Customized probe annotation file for the Nanostring nCounter Mouse PanCancer Immune Profiling Panel (catalog # 115000142). This file is provided as supporting material for a journal article.

Supplementary file 2: Microsoft Excel document with output from nSolver for differential expression analyses for pairwise comparisons noted by each named sheet. This data set is supporting material for a journal article.

Supplementary file 3: Microsoft Excel document with output from nSolver for global and directed significance scores for immune pathways. This data set is supporting material …

Nicotine Replacement Therapies To Decrease Withdrawal Symptoms And Improve Patient Experience, Cheryl Pawloski, Holly Stewart, Devon Gillis, Dena Whitesell, Maya Bulman, Christopher Racine, Raymond Serrano, Leslie Gatcombe-Hynes, Elizabeth Mullany, Amy Mcauliffe, Jayne Weisberg, Amy Sparks, Suneela Nayak, Stephen Tyzik, Ruth Hanselman

Operations Transformation

Smoking is one the leading causes of preventable death in the United States. Patient centered care revolves around encouraging patients to reduce their chances of preventable disease and death. To that end, nicotine replacement therapy (NRT) prescribed within 24 hours of hospital admission increases the chance of quitting and decreases the chance of nicotine withdrawal.

A pilot performance improvement project was initiated on two cardiac units at an academic tertiary medical center. The goal the project was to have NRT ordered within 24 hours of admission 100% of the time. Baseline metrics demonstrated admission NRT orders were below acceptable levels …

Symmetrical Peripheral Gangrene Associated With Low Output Cardiac Failure., Sijan Basnet, Priya Rajagopalan, Rashmi Dhital, Ataul Qureshi

Department of Medicine Faculty Papers

Symmetrical peripheral gangrene (SPG) is a rare entity characterized by ischemic changes of the distal extremities with maintained vascular integrity. We present the case of a 64-year-old man with bilateral necrotic toes and deranged liver function tests. This was thought to be related to severely depressed ejection fraction from non-ischemic etiology, presumably chronic alcohol ingestion. We hope that awareness of SPG and association with a low output state will aid in early detection and prevention.

Symmetrical Peripheral Gangrene Associated With Low Output Cardiac Failure., Sijan Basnet, Priya Rajagopalan, Rashmi Dhital, Ataul Qureshi

Reading Hospital Internal Medicine Residency

Symmetrical peripheral gangrene (SPG) is a rare entity characterized by ischemic changes of the distal extremities with maintained vascular integrity. We present the case of a 64-year-old man with bilateral necrotic toes and deranged liver function tests. This was thought to be related to severely depressed ejection fraction from non-ischemic etiology, presumably chronic alcohol ingestion. We hope that awareness of SPG and association with a low output state will aid in early detection and prevention.

Barriers To Epilepsy Care In Central Uganda, A Qualitative Interview And Focus Group Study Involving Plwe And Their Caregivers, Martha Sajatovic, Carol Blixen

Faculty Scholarship

Background: Epilepsy is a common neurological disease with substantial impact on the subject and their caretakers. This exploratory study identified barriers to care for persons living with epilepsy (PLWE) to develop a culturally acceptable nurse led self-management intervention for PLWE previously developed in the United States. Methods: The study involving 48 participants (31 PLWE and 17 caregivers) with in depth interviews and focus groups was conducted. We obtained insights into barriers to care in PLWE and their caregivers. Using a thematic analytic procedure emphasizing the dominant themes the qualitative responses were analyzed. Median age of PLWE was 24 years (IQR …

Off With Their Heads! How China's Controversial Human Head-Transplant Procedure Exceeds The Parameters Of International Ethical Standards In Human Experimentation, Deena Agamy

Georgia Journal of International & Comparative Law

No abstract provided.

2019 July 16 - Medical Student Education Committee Minutes, Medical Student Education Committee, East Tennessee State University

Medical Student Education Committee Minutes

No abstract provided.

Developing Physician Educational Competencies For The Management Of Female Genital Cutting: A Call To Action, Holly G. Atkinson, Amaris Geisler

Publications and Research

Female genital cutting (FGC), also called female genital mutilation, is defined as “all procedures involving partial or total removal of the external female genitalia or other injury to the female genital organs whether for cultural, religious, or other nontherapeutic reasons.” FGC can have significant health consequences, including multiple physical and psychological complications, throughout the life course. Despite violating numerous human rights and existing legal prohibitions, the practice continues. In the United States, FGC is becoming increasingly prevalent, however, physicians are not routinely trained to care for these patients. Despite the evidence of the need, there is a woeful lack of …

Gut Microbiome: Profound Implications For Diet And Disease, Ronald D. Hills Jr., Benjamin A. Pontefract, Hillary R. Mishcon, Cody A. Black, Steven C. Sutton, Cory R. Theberge

Pharmaceutical Sciences Faculty Publications

The gut microbiome plays an important role in human health and influences the development of chronic diseases ranging from metabolic disease to gastrointestinal disorders and colorectal cancer. Of increasing prevalence in Western societies, these conditions carry a high burden of care. Dietary patterns and environmental factors have a profound effect on shaping gut microbiota in real time. Diverse populations of intestinal bacteria mediate their beneficial effects through the fermentation of dietary fiber to produce short-chain fatty acids, endogenous signals with important roles in lipid homeostasis and reducing inflammation. Recent progress shows that an individual’s starting microbial profile is a key …

Understanding Opioid Users’ Views On Fentanyl Could Help Reduce Overdoses, Kate Mclean, Shannon M. Monnat, Khary Rigg, Glenn Sterner, Ashton Verdery

Population Health Research Brief Series

The opioid overdose crisis is a national public health emergency, made much worse in recent years by the widespread emergence of fentanyl – a highly potent synthetic opioid. This research brief summarizes the findings from their research conducted in southwestern Pennsylvania in 2017 and 2018. Results show that the majority of interviewees who use opioids are fearful of and want to avoid fentanyl and would utilize harm reduction strategies such as fentanyl test strips if they were made more widely available.

Adopting The Direct Anterior Approach: Experience And Learning Curve In A Chinese Patient Population., Xiangpeng Kong, Luis Grau, Alvin Ong, Charlie Yang, Wei Chai

Rothman Institute Papers

BACKGROUND: There are concerns regarding the complications encountered during the learning curve when switching to a direct anterior approach (DAA) for total hip arthroplasty (THA). The purpose of our study is to report our outcomes and complications after adopting a new approach in a Chinese patient population.

METHODS: From 2016 to 2018, a single surgeon's first 100 cases with unilateral DAA for THA were reviewed. The patients were divided into 2 groups, the first 50 cases were designated as group A and the second 50 cases were designated as group B. The preoperative, intraoperative, and postoperative clinical data were analyzed. …

Association Between Abdominal Aortic Calcification, Bone Mineral Density And Fracture In Older Women, Joshua R. Lewis, Celeste J. Eggermont, John T. Schousboe, Wai H. Lim, Germaine Wong, Ben Khoo, Marc Sim, Mingxiang Yu, Thor Ueland, Jens Bollerslev, Jonathan M. Hodgson, Kun Zhu, Kevin E. Wilson, Douglas P. Kiel, Richard L. Prince

Research outputs 2014 to 2021

Although a relationship between vascular disease and osteoporosis has been recognized, its clinical importance for fracture risk evaluation remains uncertain. Abdominal aortic calcification (AAC), a recognized measure of vascular disease detected on single‐energy images performed for vertebral fracture assessment, may also identify increased osteoporosis risk. In a prospective 10‐year study of 1,024 older predominantly Caucasian women (mean age 75.0±2.6 years) from the Perth Longitudinal Study of Aging cohort we evaluated the association between AAC, skeletal structure and fractures. AAC and spine fracture were assessed at the time of hip densitometry and heel quantitative ultrasound. AAC was scored 0 to 24 …

Bitter Taste Receptors For Asthma Therapeutics., Ajay P. Nayak, Sushrut D. Shah, James V. Michael, Deepak A. Deshpande

Center for Translational Medicine Faculty Papers

Clinical management of asthma and chronic obstructive pulmonary disease (COPD) has primarily relied on the use of beta 2 adrenergic receptor agonists (bronchodilators) and corticosteroids, and more recently, monoclonal antibody therapies (biologics) targeting specific cytokines and their functions. Although these approaches provide relief from exacerbations, questions remain on their long-term efficacy and safety. Furthermore, current therapeutics do not address progressive airway remodeling (AR), a key pathological feature of severe obstructive lung disease. Strikingly, agonists of the bitter taste receptors (TAS2Rs) deliver robust bronchodilation, curtail allergen-induced inflammatory responses in the airways and regulate airway smooth muscle (ASM) cell proliferation and mitigate …

Alerts For Community Pharmacist-Provided Medication Therapy Management: Recommendations From A Heuristic Evaluation, Margie E. Snyder, Heather A. Jaynes, Stephanie A. Gernant, Julie Diiulio, Laura G. Militello, William R. Doucette, Omolola A. Adeoye-Olatunde, Alissa L. Russ

Department of Pharmacy Practice Faculty Publications

Background
Medication therapy management (MTM) is a service, most commonly provided by pharmacists, intended to identify and resolve medication therapy problems (MTPs) to enhance patient care. MTM is typically documented by the community pharmacist in an MTM vendor’s web-based platform. These platforms often include integrated alerts to assist the pharmacist with assessing MTPs. In order to maximize the usability and usefulness of alerts to the end users (e.g., community pharmacists), MTM alert design should follow principles from human factors science. Therefore, the objectives of this study were to 1) evaluate the extent to which alerts for community pharmacist-delivered MTM align …

Review Of Pediatric Care Online, Terri Gotschall

Faculty Scholarship and Creative Works

This guide to scholarly activities provides early- and mid-career health sciences librarians with a path to immersing in scholarly activities. The four levels walk librarians through increasing stages of scholarship. Early-career librarians will begin at the first level, navigating from discovering mentors and areas of research interest to level two, publishing a resource or book review and finding their first public speaking opportunity. More experienced librarians will find where they are on the path and continue to build their scholarship all the way to conducting and publishing original research and becoming leaders in their field.

Subtypes In Patients With Opioid Misuse: A Prognostic Enrichment Strategy Using Electronic Health Record Data In Hospitalized Patients, Majid Afshar, Cara Joyce, Dmitriy Dligach, Brihat Sharma, Robert Kania, Meng Xie, Kristin Swope, Elizabeth Salisbury-Afshar, Niranjan S. Karnik

Biostatistics Collaborative Core: Faculty Publications and Other Works

Background: Approaches are needed to better delineate the continuum of opioid misuse that occurs in hospitalized patients. A prognostic enrichment strategy with latent class analysis (LCA) may facilitate treatment strategies in subtypes of opioid misuse. We aim to identify subtypes of patients with opioid misuse and examine the distinctions between the subtypes by examining patient characteristics, topic models from clinical notes, and clinical outcomes.

Methods: This was an observational study of inpatient hospitalizations at a tertiary care center between 2007 and 2017. Patients with opioid misuse were identified using an operational definition applied to all inpatient encounters. LCA with eight …

Use Of Plasmapheresis And Immunosuppressants To Treat Diffuse Alveolar Hemorrhage In A Patient With Granulomatosis With Polyangiitis., Yasar Sattar, Ammu Thampi Susheela, Waqas Ullah, Norina Usman, Fnu Zafrullah

Abington Jefferson Health Papers

Granulomatosis with polyangiitis (GPA) is a systemic granulomatous inflammatory disease characterized by small-to-medium vessel vasculitis due to Central Anti-Neutrophil Cytoplasmic Antibody (C-ANCA). GPA commonly involves the lungs and the kidneys. Among the pulmonary manifestations, diffuse alveolar hemorrhage (DHA) is a rare presentation of GPA that can present with hemoptysis leading to acute onset of anemia and hemodynamic instability. An active diagnostic workup including serologic titer of C-ANCA, imaging, intensive care, and aggressive immunosuppression is the key to DAH management. We report a case of DAH secondary to GPA that presented with hemoptysis leading to severe anemia, initially resuscitated symptomatically and …

Audience Response Systems And Missingness Trends: Using Interactive Polling Systems To Gather Sensitive Health Information From Youth., Tammy Toscos, Michelle Drouin, Mindy Flanagan, Maria D. Carpenter, Connie Kerrigan, Colleen Carpenter, Cameron Mere Mba, Marcia Haaff

Health Services and Informatics Research

BACKGROUND: The widespread availability and cost-effectiveness of new-wave software-based audience response systems (ARSs) have expanded the possibilities of collecting health data from hard-to-reach populations, including youth. However, with all survey methods, biases in the data may exist because of participant nonresponse.

OBJECTIVE: The aims of this study were to (1) examine the extent to which an ARS could be used to gather health information from youths within a large-group school setting and (2) examine individual- and survey-level response biases stemming from this Web-based data collection method.

METHODS: We used an ARS to deliver a mental health survey to 3418 youths …