Medicine and Health Sciences Commons^™

Display Design To Avoid And Mitigate Limit Cycle Oscillations On The F-16c, David Feibus

International Symposium on Aviation Psychology - 2021

The U.S. Air Force F-16C’s flight envelope is defined by its external weapon stores configuration, and the employment of some munitions at certain speeds can cause the F-16 to enter a flutter-like state called Limit Cycle Oscillations (LCO). In LCO, the pilot experiences turbulent vibrations reducing their fine motor control. The current research attempted to help pilots anticipate an LCO-susceptible configuration by projecting the consequences of employing certain munitions. It was hypothesized that the new displays would result in fewer flight envelope violations, fewer LCO occurrences, and increased situation awareness. The results show that there are situation awareness benefits if …

Systematic Review Of Weather Observation And Forecast Resources Available To General Aviation Pilots, J W. Wallace, Nicoletta Fala

International Symposium on Aviation Psychology - 2021

Weather continues to be a consistent hazard for pilots despite decades of progress in both pilot education and weather observation and forecasting technology. Much research has been done on the various facets of this problem, from pilot psychology to the weather information sources themselves. Weather-Intelligent Navigation Data and Models for Aviation Planning (WINDMAP) is a NASA University Leadership Initiative (ULI) that aims to use Unmanned Aerial Systems (UAS) to improve the accessibility and accuracy of weather information for General Aviation (GA) pilots and UAS operators. This paper aims to produce a systematic review of research on the topic using the …

Psychological Aspects In Pilot Training: Cognition And Human Factors, Shagun Gupta

International Symposium on Aviation Psychology - 2021

Introduction-International Civil Aviation Organization’s (ICAO) SHELL model was designed to study and investigate the way the pilot interacted with the various dimensions of the model. Aim-The present study aimed to explore psychological aspects while flying using the dimensions of ICAO’s SHELL model of aviation. Methods-The study followed the qualitative research paradigm. The sample consisted of 9 (Males =4, Female =5) student trainee pilots in the age range of 18 – 21 years. They were subjected to in-depth interviews which lasted for around 30 minutes. The data were analyzed using the thematic network of analysis. Results-The results show that in the …

Identification Of A Failed Engine In Twin-Engine Propeller Aircraft: Pilot Surveys, Andrey K. Babin, Andrew R. Dattel

International Symposium on Aviation Psychology - 2021

Twin-engine propeller aircraft accidents occur for many reasons including misidentifying a failed engine. Pilots learn to use a procedure called dead leg-dead engine to identify the failed engine; however, misidentification of the failed engine still occurs, questioning the effectiveness of this procedure. Two surveys were created. Survey 1 was completed by 49 airline pilots operating twin-engine turboprop aircraft; Survey 2 was completed by 22 instructor pilots operating twin-engine piston aircraft. Survey 1: Average flight time was 6,230 hours. Approximately 19% of respondents reported using the Engine-Out procedure at least once. Twenty-nine percent agreed that there could be a better method …

Go-Around Noncompliance During Unstabilized Approaches And Landings In Commercial Aviation: A Human Factors Analysis, Garrin Ross, Linda Tomko

International Symposium on Aviation Psychology - 2021

Informed by findings and recommendations from the Flight Safety Foundation’s Approach and Landing Accident Reduction Task Force, we examined and analyzed Aviation Safety Reporting System (ASRS) incident report data from unstabilized approach and landing events. The aim of this study was to investigate the human factors reported as contributing to operational incidents of unstabilized approaches and landings in United States-based commercial aviation. Results showed the unstabilized approaches were significantly less likely to be responded to with go-around compliance. Binomial logistic regression analysis revealed descriptive differences in the associations of the ASRS-coded human factors with the likelihood of unstabilized approaches being …

Comparing Human And Machine Learning Classification Of Human Factors In Incident Reports From Aviation, Claas Tido Boesser, Florian Jentsch

International Symposium on Aviation Psychology - 2021

Machine learning algorithms have become popular tools for automated classification of text; however, performance of such algorithms varies and depends on several factors. We examined how a subjective labeling process based on a human factors taxonomy can influence human, as well as automated, classification of safety incident reports from aviation. In order to evaluate these challenges, we trained a machine learning classifier on a subset of 17,253 incident reports from the NASA Aviation Safety Reporting System using multi-label classification, and collected labels from six human annotators for a representative subset of 400 incident reports each, resulting in a total of …

Minimizing The Negative Impacts Of Airport Construction, Sarah Hubbard, Bryan Hubbard, Joseph Sobieralski

International Symposium on Aviation Psychology - 2021

Airfield infrastructure projects are critical to ensure facilities are safe, in good condition and meet current standards. However, these airfield construction and reconstruction activities are usually conducted on an active airfield, which impose operational and human factors challenges for all users, including pilots, air traffic controllers, airport operations personnel, construction workers, and emergency responders. FAA recognizes the potential safety challenges, and provides supporting guidance and regulation as described in AC 150/5370-2G, Operational Safety on Airports During Construction. While this guidance is valuable and enhances safety, there remain human factors issues that are worthy of investigation and discussion.

Identifying Opportunities For Augmented Cognition During Live Flight Scenario: An Analysis Of Pilot Mental Workload Using Eeg, Nicholas Wilson, Hamed Taheri Gorji, Jessica Vanbree, Bradley Hoffmann, Kouhyar Tavakolian, Thomas Petros

International Symposium on Aviation Psychology - 2021

Augmented cognition is a form of human-systems interaction in which physiological sensing of a user’s cognitive state is used to precisely invoke system automations when needed. The present study monitored the in-flight physiological state of the pilot to determine the optimal combination of EEG indices to predict variations in workload, or opportunities for augmented cognition.The [sic] participants were 10 collegiate aviation students with FAA commercial pilot certificates and current medical certificates. Each participant performed a uniform flight scenario that included procedures that varied in workload demands. All maneuvers were performed while simultaneously acquiring EEG data in flight. The EEG data …

Metacognitive Situation Awareness In Aviation, Haydee M. Cuevas, Marisa D. Aguiar

International Symposium on Aviation Psychology - 2021

This exploratory study was aimed at gaining a better understanding of metacognitive situation awareness. Seven subject matter experts, two each for commercial aviation and aviation maintenance and three for air traffic control, were asked to define ‘situation awareness’ as it relates to their job and identify the knowledge, skills, and strategies enabling them to effectively monitor, evaluate, and regulate their situation awareness as they perform their job. Findings from this line of research can guide the design, development, and evaluation of approaches for enhancing and assessing metacognitive situation awareness.

Assessment Of A Horizontal-Vertical Anisotropy In Utilizing An Aircraft Attitude Symbology, George A. Reis, Michael E. Miller, Eric E. Geiselman, David W. Dommett, Brent T. Langhals, Christine M. Schubert Kabban, Julie A. Jackson

International Symposium on Aviation Psychology - 2021

This study examined how visual field performance asymmetries affect visual processing of complex, meaningful visual stimuli, such as the Arc-Segmented Attitude Reference (ASAR). Participants’ performance was collected in their recall and report of attitude information after briefly presented ASAR symbology within the peripheral visual field. Visual processing of the ASAR was assessed when making coordinate and categorical judgments at cardinal display locations for each of several flight contexts (roll left/right, climb, and dive). Primarily in coordinate tasking, performance trends were consistent with the horizontal-vertical anisotropy literature—performance is better on the horizontal meridian over the vertical meridian in the field of …

Dean's Research Newsletter, May 2021, Jerry L. Nadler

SOM Dean's Research Newsletter

No abstract provided.

Improving Quality Of Life Among Individuals With Neurocognitive Disorders Using Occupational Therapy And A Sensory Integration Approach, Makenzie K. Johnson

Occupational Therapy Capstone Presentations

Abstract

Currently, 50 million people worldwide are affected by major neurocognitive disorder (MND). Those with MND often exhibit behavioral and psychological symptoms that have a significant impact on occupational participation and overall quality of life. Symptoms are frequently treated with anti-psychotics; however, a need for a non-pharmacological approach to alleviate these symptoms is indicated through current research. This 14-week Capstone experience was completed in the memory care neighborhoods at Sunrise Retirement Community in Sioux City, Iowa. Throughout this experience, knowledge related to effective caregiving strategies and sensory based interventions was enhanced, education was provided to memory care staff and occupational …

Himmelfarb Headlines - May/June 2021, George Washington University, Himmelfarb Health Sciences Library

Himmelfarb Headlines (2009 - present)

News, information, and resources relating to Himmelfarb Library that is of interest to patrons.

Simulation Based Clinical Systems Testing Of A Pediatric Ed To Improve Staff And Process Readiness For Pediatric Hypoglycemia, Kevin Meilak Md, Christopher S. Kennedy

Posters

Background: Hypoglycemia is the most common metabolic disorder in children in pediatric emergency department (ED) settings 1. Children may present with nonspecific symptoms, or asymptomatically2. So identification/treatment is very challenging. Delayed recognition and under treatment can lead to poor patient outcomes including seizure, coma, and death. Simulation-based clinical systems tests (SbCSTs) are useful to detect gaps/latent safety threats (LSTs) in system design.3-5


Objective: Our aim was to use SbCSTs combined with rapid cycle training to test system function for ED treatment of hypoglycemia.3-5. The research questions were in 2 frames: 1. Can SbCSTs identify gaps/LSTs and recommendations for improvement and …

Assessing The Effects Of Social Determinants On Serious Safety Events, Lisa L. Schroeder, Jessi Van Roekel, John Cowden

Posters

Background: We have long known that various social determinants of health (SDH) such as race, gender, socioeconomic status and others can affect health outcomes, such as readmission rates and mortality. To our knowledge, the impact of SDH on safety events has not been studied.


Objective: We sought to understand the role that social determinants may play in contributing to safety events at our institution and to incorporate this information into the creation of corrective action items following the serious safety event.


Design/Methods: The Clinical Safety team partnered with the Office of Equity and Diversity to develop a standard question regarding …

Online Echocardiography Modules For Pediatric Cardiology Fellows, Sarah Studyvin, Doaa Aly, Laura Kuzava, Tyler Johnson, Alison Samrany, Nitin Madan, Sanket Shah

Posters

Background: Adequate echocardiographic (echo) education is integral to successful cardiology training. Online education is proven to be effective in other specialties, but pediatric echo training data are lacking. Our aim was to design and assess the role of a novel online module-based curriculum to enhance pediatric cardiology fellows’ echo education.

Methods: Four interactive modules, focused on principles and interpretation of a normal echo, were delivered to fellows. Content included high quality 2D and 3D echo clips (Fig 1A) as well as interactive quizzes (Fig 1B) and could be accessed from a phone, tablet, or computer. All fellows completed pre- and …

Fentanyl-Induced Wooden Chest Syndrome Masquerading As Severe Respiratory Distress Syndrome In Covid-19, Grace Judd, Rachael Starcher, David Hotchkin

Providence Portland Medical Center Internal Medicine 2021

Case Presentation

History •47 yo M with no PMH presented with fever and respiratory distress •Admitted for COVID-19 pneumonia Hospital Course •Intubated for moderate acute respiratory distress syndrome (ARDS) on hospital day 11 •Fentanyl infusion started •Hypoxia improved within 36 hrsbut plateau pressures consistently >30 cm H2O despite minimizing dead space •Trial of airway pressure release ventilation worsened hypercarbia •Bronchoscopy w/o mucous plugging, airway collapse, or purulent secretions •Lung compliance worsened (Pplat=50 on 4 cc/kg) w/o change in oxygenation •Developed suspicion for wooden chest syndrome (WCS) and discontinued fentanyl Outcome •Pplatnadired at 16 within one hour after stopping fentanyl •Pt …

Evaluating The Caprini Risk Assessment In An Inpatient Rehabilitation Facility, Alissa Payne, Kelsey Boersma, Sarah Nechuta

Masters Projects

Deep vein thrombosis (DVT) is an often underdiagnosed disease that can be life threatening for individuals. Currently, the best practice approach to assess the risk of venous thromboembolism (VTE) in patients within a rehabilitation hospital is unknown. We examined how well the Caprini risk assessment (CRA) score predicts VTE events (deep vein thrombosis (DVT), pulmonary embolism (PE)) within an inpatient rehabilitation hospital. Between January 2015 and October 2020, VTE events, the CRA Score, and risk factors were collected from a chart review conducted at Mary Free Bed Rehabilitation Hospital (MFB) among 3,091 patients. Results from the unadjusted logistic regression model …

The Effectiveness Of The More Than Sad School Based Gatekeeper Training Program, Guy Diamond, Lawrence Ogunkua, Matthew B. Wintersteen, Tita Atte, Perri Rosen, Robert Gallop

Department of Psychiatry and Human Behavior Faculty Papers

Schools have the unique opportunity to identify and refer youth at risk for suicide. School-based gatekeeper training programs aim to improve staff’s ability to talk to students about mental health concerns and refer them for an assessment. Unfortunately, progress in evaluating the available programs has been limited. In fact, the popular and widely used More Than Sad program has received no rigorous evaluation to date. This study sets out to evaluate the effectiveness of the More Than Sad program in a quasi-experimental, wait-list control design with a large number of school personnel, across geographically diverse communities. Fourteen school districts with …

Medicare-Paid Naloxone: Trends In Non-Metropolitan And Metropolitan Areas, Chris Delcher, Yue Cheng, Minji Sohn, Jeffery C. Talbert, Patricia R. Freeman

Rural & Underserved Health Research Center Publications

Overview of Key Findings

• Medicare pays for the largest share (> 30%) of naloxone dispensed from retail pharmacies in non-metropolitan areas.
• Medicare-paid dispensing has grown since 2013, but from 2017-2018 dispensing growth in non-metropolitan areas slowed considerably compared to metropolitan areas (42% v 121%, respectively).
• As of 2018, the rate of naloxone dispensing to Medicare enrollees in metropolitan areas was approximately double that in non-metropolitan areas (4.9 v 2.9 per 1,000 enrollees, respectively).

Where Are They Now? Spanish Utilization And Career Direction Of Graduates Of A Pediatric Bilingual Continuity Clinic, Jodi Dickmeyer, Katie Mcanany, Sarah Stone, John Cowden

Posters

Background: The Clínica Hispana de Cuidados de Salud (CHiCoS) Program was created in 2009 to prepare bilingual (English-Spanish) pediatric residents to independently give safe, effective care to Spanish-speaking families. By providing 1:1 support from a culture and language coach over three years of residency, CHiCoS has improved residents’ cultural and linguistic skills and families' perceptions of care. The effects of such training on residents’ future careers have not been formally studied.


Objective: To describe the careers of former CHiCoS residents, the impact of culture and language training on their practice, and opportunities for post-CHiCoS cultural and language training.


Design/Methods: In …

Covid-19: Exploring The Probability Of Disease Extinction - A Modeling And Simulation Study, Donald Porchia

Electronic Theses and Dissertations, 2020-2023

There are two distinct topics considered in this dissertation. The first is the formulation of a compartmental model using reactive social distancing in which disease transmission changes as a function of the state variables of the model; in this case, the cumulative incidence. The model assumes a single strain epidemic of Covid-19 in the United States and is used to estimate the cumulative number of deaths due to the epidemic where incidence data is used to calibrate and validate the model. The second topic concerns the use of the stochastic threshold to determine disease persistence or extinction. The Covid-19 pandemic …

Economic And Cost-Effectiveness Analysis Of The Community-Level Interventions For Pre-Eclampsia (Clip) Trials In India, Pakistan And Mozambique, Jeffrey N. Bone, Asif R. Khowaja, Marianne Vidler, Beth A. Payne, Mrutyunjaya B. Bellad, Shivaprasad S. Goudar, Ashalata A. Mallapur, Khatia Munguambe, Rahat Qureshi, Zulfiqar Ahmed Bhutta

Woman and Child Health

Background: The Community-Level Interventions for Pre-eclampsia (CLIP) trials (NCT01911494) in India, Pakistan and Mozambique (February 2014-2017) involved community engagement and task sharing with community health workers for triage and initial treatment of pregnancy hypertension. Maternal and perinatal mortality was less frequent among women who received ≥8 CLIP contacts. The aim of this analysis was to assess the incremental costs and cost-effectiveness of the CLIP intervention overall in comparison to standard of care, and by PIERS (Pre-eclampsia Integrated Estimate of RiSk) On the Move (POM) mobile health application visit frequency.
Methods: Included were all women enrolled in the three …

When Your Patient Does Know Best: A Lesson In Geriatrics, Daphne Sy, Jeff Youker

Providence St. Vincent Internal Medicine 2021

Introduction

An athletic elderly woman presented to the emergency department (ED) with subjective leg weakness, most notably while climbing stairs. The patient’s insistence that we acknowledge her change in functional status prompted a workup that exposed an active pauci-immune crescentic glomerulonephritis. She was diagnosed with an unusual presentation of granulomatosis with polyangiitis (GPA) which was discovered in time to initiate treatment and prevent renal failure.

Case Report

A 77 year-old woman with a past medical history of chronic kidney disease (CKD) and biopsy-negative pulmonary nodules presented to the ED with a unique complaint: she could no longer climb multiple stairs …

Avoiding Rash Decisions: A Guide To Adverse Cutaneous Drug Reactions, Caleb Freeman, Tom Chau

Providence St. Vincent Internal Medicine 2021

No abstract provided.

A Dramatic Presentation Of Plasmablasticlymphoma In Untreated Hiv, Joshua Genstler, Alex Schafir

Providence St. Vincent Internal Medicine 2021

No abstract provided.

Are Elevated Inflammatory Markers And Acute Phase Reactants Associated With More Severe Disease In Covid 19 Patients?, Joanna Bove, Robert Kim, Shelley Sanders

Providence St. Vincent Internal Medicine 2021

Introduction Inflammatory markers and acute phase reactants (from here referred to as “markers”) are associated with COVID-19 infection and may be able to predict disease severity.1,2We collected markers including d-dimer (ug/mL), ferritin (ng/mL), CRP (mg/dL), and creatinine kinase (CK) (IU/L) on admission and periodically throughout the hospital stay for 50 patients admitted with COVID-19 infection. We hypothesized that higher levels of markers at admission and during hospitalization are associated increased severity of disease, such as ICU admission and placement on mechanical ventilation.

Methods From March to May 2020, we identified 50 patients admitted to Providence St. Vincent Medical Center with …

A Case Of Succinylcholine-Induced Postoperative Myalgia, Nancy Ha, Stephanie Griffith

Providence St. Vincent Internal Medicine 2021

Introduction

Succinylcholine is a commonly used depolarizing neuromuscular blocking agent in anesthesia for relaxation of the skeletal muscles during endotracheal intubation. It is ideal for use in shorter surgical cases and situations where a rapid sequence intubation is warranted due to its quick onset and short duration of action. One documented side effects of succinylcholine is postoperative myalgia, which was first described in the literature in 1952.

Case Report

An 88 y.o. male presented two days following transurethral resection of a bladder mass with complaints of diffuse myalgias that were severely limiting activity. The pain was greatly exacerbated by any …

When Two Isn’T Better Than One: A Case Of Severe Hyponatremia From Combination Thiazide Diuretic And Arb Therapy, Jillian Catral, Emily Hitchcock

Providence St. Vincent Internal Medicine 2021

Introduction

Thiazide diuretics and angiotensin II receptor blockers (ARB) are common medications for hypertension and are widely used together to counteract thiazide-induced hypokalemia •Thiazide-associated hyponatremia (TAH) is fairly common. There are also multiple case series in the literature of severe hyponatremia in elderly pts attributed to initiation of a thiazide-ARB combination, even when the thiazide dose was low. This is a unique case of hyponatremia in which ARB on thiazide therapy seems to have precipitated severe hyponatremia.

Case Report This is a 74-year-old female with a history of essential hypertension with intolerance to several antihypertensive medications, post-operative hyponatremia after laminectomy …

Aplastic Anemia Secondary To Sars-Co-V-2, Maya Wernick, Stacy Lewis, Christie Moore

Providence St. Vincent Internal Medicine 2021

No abstract provided.